PM on plans for a seven-day NHS

David Cameron yesterday gave a speech setting out his plans for "a 7-day NHS, safe in our hands - for every generation to come".

This is my first major speech since returning to Downing Street after the election, and I wanted to come here to talk about one of the issues closest to my heart – our National Health Service.

I said on the steps of Downing Street that this would be a one nation government acting in the interests of all working people.

And there is nothing that embodies the spirit of one nation coming together – nothing that working people depend on more – than the NHS.

Our commitment to free healthcare for everyone – wherever you are and whenever you need it.

Values

The National Health Service should unite and bind us all. And yet during the election campaign a lot of rubbish was said about my plans.

So first of all today I want to put the record straight loud and clear. They said we would cut the NHS. We haven’t and we won’t.

In fact, we increased spending in real terms every year in the last Parliament, and we’ll increase it in real terms every year in this Parliament too, rising to at least an extra £8 billion a year by 2020.

They said we cut the numbers of doctors and nurses. We didn’t. Today there are over 9,400 more doctors and over 7,700 more nurses treating more people better than ever before.

They said we would privatise the NHS. It’s just not true. The founding values of the NHS are my values. The NHS will always be free for everyone under a Conservative government.

And when people ask about other healthcare providers being given the chance to deliver some services as part of the NHS, I say, think of organisations like Age UK, Whizz-Kidz and Macmillan Cancer nurses. Shouldn’t we have that sort of incredible care and support available for free on the NHS? Of course we should.

Tony Blair and Gordon Brown both thought so too.

They didn’t privatise the NHS – and neither will I.

Our NHS should always be the best. That means getting the best care and making that care available for everyone – free - wherever they are and whenever they need it.

Let’s assess the NHS over the last 5 years. Thanks to the incredibly hard work of our NHS staff, the Commonwealth Fund ranked our health service as the best in its recent international study.

Yes, there are challenges. The pressures on A&E. The rising cost of social care. The growing numbers of people with dementia.

These are the things we do talk about. And rightly so.

But then there are the things we don’t talk about so much today – because they are well on their way to being sorted.

Remember the column inches that used to be given over to hospital acquired infections; the cover-ups of hospital scandals; the queues for the dentist; the mixed sex wards.

And then there’s the progress we’ve made on fighting the big killers.

Survival rates for stroke, cancer and heart disease are all up, and the Cancer Drugs Fund we created has given life-saving drugs to over 65,000 people.

And what does all this mean?

It means more people hearing those magic words “all clear” – and more precious loved ones getting better.

And you know the accusation that hurt me the most? It’s when people said the NHS wouldn’t be safe in our hands. Let’s remember. We’re the ones that had to clear up the appalling mess at Mid-Staffordshire. We’re the ones who finally gave the whistle blowers the protection they needed to speak out. We’re the ones who have put quality, safety and compassion back at the heart of the NHS.

I don’t apologise for being angry about this.

When you have depended on the NHS like Samantha and I have. When you have known what it feels like to have your whole world in the hands of doctors and nurses. And when you see how these incredible people are doing everything they can for your family, it changes your life forever.

My love of the NHS, my respect for the NHS, my commitment to the NHS runs through every sinew of my body.

The NHS is safe in my hands. And don’t let anyone ever tell you otherwise.

The plan

Now, what we should have been discussing in the election campaign was how we meet the huge challenges facing healthcare today right across the world.

These are the challenges that my first-rate Health Secretary – Jeremy Hunt - and his team are focused on. How we adapt to take advantage of the incredible opportunities presented by the advance of science and technology, and how the NHS evolves to support people living longer and coping with more complex health conditions.

We know what these challenges mean. We know how incredibly hard our doctors and nurses are working. We understand the pressures they face day and night. We get the worries and concerns people have about the future.

That’s why it’s not enough just to have the right values in the NHS; we have to have the right plan for the future too.

And we’ve got that plan.

One of the most significant achievements of the coalition government was to make the NHS more independent. We set the NHS free to develop its own plan. And led by its fantastic Chief Executive Simon Stevens – NHS England has done just that.

I think there are many excellent aspects to the plan.

As Simon has said this morning, when you look at the costs of obesity, smoking, alcohol and diabetes, we know we need a completely new approach to public health and preventable diseases. A real focus on healthy living. That’s why it’s at the heart of the plan.

We also know that we need to stop patients being bounced around the health system: having to tell umpteen people the same thing over and over again just to get their problem treated properly.

That means we must have proper joined up care built around what patients need: family doctors working together with hospital doctors, community nurses and carers and electronic health records available at the touch of a fingertip, all giving patients a real say over how they are cared for and who cares for them.

That’s all in the plan.

So is a new deal for GPs with more investment, more training and a more personal link with patients. So is faster access to new drugs and treatments. And so is a proper focus on mental health.

Mental health

Today 1 in 4 in the UK has a mental health condition. Let’s think about what that means for a moment. It means behind most doors in Britain you will find a family that includes someone dealing with a mental health condition.

Whether it’s a Dad off work with stress; a Mum suffering panic attacks; a teenager with an eating disorder or a lonely grandfather coping with depression – people should not suffer in silence.

In the coalition government we took bold decisions, legislating to ensure that mental and physical health conditions were treated as equal and investing more in mental health support for mothers during and after pregnancy. And now we’re going further – with full transparency over the quality of mental health services in every part of the country.

Just as we are doing for physical healthcare, we will publish information on how good mental health services are, so everyone can see where care is best and where we need to act to make it better.

So we are getting behind this whole plan. The plan that the NHS itself has developed for its own future. And a plan for a strong NHS that can only be delivered with a strong economy.

Because of our long-term economic plan, we can and will back this long-term health plan for our country.

In return the NHS must step up. There is no choice between efficiency savings and quality of care. Delivering the quality of care that we all want to see depends on delivering the efficiencies at the heart of this plan. It’s a big responsibility.

And it’s going to require some tough decisions and tough actions to deliver the transformation set out in the plan. But I’m confident that the NHS can do this under Simon’s leadership. We’re backing this plan together. As I said to Simon earlier: “I’m funding it. He’s delivering it.”

The vision

But as we see this through, so we also need to keep our eyes on the main prize.

Too often talk about healthcare can get bogged down in statistics and technocratic terms. But there’s actually a big vision at the heart of this plan.

A vision of a modern NHS working for you 7 days of the week – when you need it, where you need it.

And that begins with a transformation of primary care – just as we are beginning to see at the Vitality Partnership here in Birmingham. One of the great winners of my access fund - supporting GP surgeries to open 8 till 8, 7 days a week.

Vitality are dramatically increasing the range of services available in one place; the times those services are available and the ease of booking them.

So here’s our vision. Rethinking what primary care can be. Prevention, not just treatment. Tackling causes, not just symptoms. Treating the whole person, not just an individual ailment.

So, for example, when an obese smoker visits his GP with a lung condition and a mental health issue, he doesn’t get sent away with a pile of pills and end up weeks later in hospital.

Instead he comes to a place like this that brings together the full suite of care services he needs. Whether that’s Cognitive Behavioural Therapy, a specialist respiratory nurse or wider health education to address the underlying causes.

He can use an app to book appointments for before or after work, order a repeat prescription online and have it delivered to his home and even use Skype, Facetime or email to get some advice without setting foot outside his front door.

By the end of this financial year 18 million patients will have access to a GP at mornings, evenings and weekends.

By the end of this Parliament I want that for everyone.

And this 7-day NHS will be just as vital in our hospitals too.

It’s a shocking fact, but mortality rates for patients admitted to hospital on a Sunday can be 16% higher than on a Wednesday, while the biggest numbers of seriously ill patients arrive at the weekend when hospitals are least well equipped to handle them.

So 7-day care isn’t just about a better service – it’s about saving lives.

We simply can’t aspire to be the safest health system in the world without this commitment.

While our hospitals are working hard Monday to Friday to get patients better, sometimes it can feel as though Saturdays and Sundays are more about just somehow getting through to Monday. Diseases don’t work weekdays 9 to 5. And neither can we.

When you have sat through a night in the hospital watching a loved one and praying for the morning; when you have spent a weekend longing for the week – you know just how important these changes are.

And let’s be absolutely clear. This isn’t about NHS staff working 7 days a week.

It’s about different shift patterns, so that our doctors and nurses are able to give that incredible care whenever it is needed.

It’s about key decision makers being around at the weekend; junior doctors being properly supported and resources like scanners up and running wherever they are needed.

Conclusion

I don’t underestimate the scale of the challenge in making all this happen.

But just as we came together as nation to create the National Health Service nearly 70 years ago, so I believe that together – by sticking to the plan – we can become the first country in the world to deliver a truly 7-day NHS.

And we must do so.

To protect and preserve the values of the NHS that are so central to our national identity.

To keep our people healthy; to look after them when they fall ill; to care for the elderly with dignity and to ensure that free healthcare is always there whenever people need it most.